Weischer Maren, Röcken Martin, Berneburg Mark
Department of Dermatology and Venerology, Eberhard Karls University, Liebermeisterstrasse 25, D-72076 Tuebingen, Germany.
Exp Dermatol. 2007 May;16(5):385-93. doi: 10.1111/j.1600-0625.2007.00555.x.
Since the introduction of cyclosporin A (CsA) in the early 1980s, the use of immunosuppressants has markedly increased. Already established drugs have proved effective in the treatment of a wide range of diseases outside transplantation medicine and new immunosuppressants have been developed for more specific indications such as psoriasis and atopic dermatitis. Patients in transplantation medicine as well as in dermatology have benefited significantly from systemic and topical application of both new and established drugs. But are these drugs without risks? Cancer-protecting effects have been reported for some of the available immunosuppressants. Conversely, other publications and the issue of a black box warning by the US Food and Drug Administration have increased concerns about cancer-promoting effects. Knowledge of the specific effects as well as adverse effects is paramount to ensure an application that is safe and beneficial for the patient. Here we review the mechanisms of action and therapeutic potential, and critically review recent literature with respect to possible carcinogenic side effects of systemic and topical CsA, tacrolimus, pimecrolimus and rapamycin.
自20世纪80年代初引入环孢素A（CsA）以来，免疫抑制剂的使用显著增加。已有的药物已被证明在移植医学以外的广泛疾病治疗中有效，并且已开发出用于更特定适应症（如银屑病和特应性皮炎）的新型免疫抑制剂。移植医学和皮肤病学领域的患者都从新型和已有的药物的全身及局部应用中受益匪浅。但这些药物是否毫无风险呢？一些现有免疫抑制剂已被报道具有抗癌作用。相反，其他出版物以及美国食品药品监督管理局发布的黑框警告增加了人们对其促癌作用的担忧。了解这些药物的具体作用以及不良反应对于确保对患者安全且有益的应用至关重要。在此，我们综述了环孢素A、他克莫司、吡美莫司和雷帕霉素全身及局部应用的作用机制和治疗潜力，并严格审视了近期关于其可能致癌副作用的文献。
